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Semin Neurol 2017; 37(02): 186-192
DOI: 10.1055/s-0037-1601887
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Impulse Control Disorders and Related Complications of Parkinson's Disease Therapy

Alexander M. Lopez
1   Department of Medicine, Meharry Medical College, Nashville, Tennessee
,
Daniel Weintraub
2   Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
,
Daniel O. Claassen
3   Department of Neurology, Vanderbilt University, Nashville, Tennessee
› Author Affiliations
Further Information

Publication History

Publication Date:
16 May 2017 (online)

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Abstract

Impulsive and compulsive behaviors in Parkinson's disease (PD) patients are most often attributed to dopamine agonist therapy; dysregulation of the mesocorticolimbic system accounts for this behavioral phenotype. The clinical presentation is commonly termed impulse control disorder (ICD): Behaviors include hypersexuality, compulsive eating, shopping, pathological gambling, and compulsive hobby participation. However, not all PD individuals taking dopamine agonists develop these behavioral changes. In this review, the authors focus on the similarities between the phenotypic presentation of ICDs with that of other reward-based behavioral disorders, including binge eating disorder, pathological gambling, and substance use disorders. With this comparison, we emphasize that the transition from an impulsive to compulsive behavior likely follows a ventral to dorsal striatal pattern, where an altered dopaminergic reward system underlies the emergence of these problematic behaviors. The authors discuss the neurobiological similarities between these latter disorders and ICDs, emphasizing similar pathophysiological processes and discussing treatment options that have potential for translation to PD patients.

Keywords

Parkinson's disease - dopamine agonist - impulse control disorder - striatum
 

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